- Centene Corporation (Jefferson City, MO)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... state, corporate, and accreditation requirements. + Assists the Chief Medical Director in the functioning of the...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
- Humana (Jefferson City, MO)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of...or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare… more
- Datavant (Jefferson City, MO)
- …SMART software experience strongly encouraged to apply **You Will:** + Conduct inpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and ... to realize our bold vision for healthcare. As an ** Inpatient Auditing Specialist** you will be instrumental in addressing...presenting solutions for customer issues. This role is fully remote with a flexible schedule, allowing you to help… more
- CenterWell (Jefferson City, MO)
- **Become a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health ... claims. The Medical Director , Primary Care work assignments involve moderately complex to...facilitation with hospitals. The clinical scenarios predominantly arise from inpatient or post-acute care environments. There are discussions with… more
- Humana (Jefferson City, MO)
- …scenarios arise from outpatient, inpatient or post-acute care environments. The Medical Director will have discussions with external physicians by phone to ... caring community and help us put health first** The Medical Director relies on medical ...or fellowship, which preferably includes some experience in an inpatient and/or outpatient environment and/or related to care of… more
- Humana (Jefferson City, MO)
- …resolution skills. Responsibilities The Medical Director provides medical interpretation and determinations on whether acute inpatient rehabilitation ... caring community and help us put health first** The Medical Director actively uses their medical...or fellowship, which preferably includes some experience in an inpatient environment and/or related to acute inpatient … more
- Humana (Jefferson City, MO)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...in care management. The clinical scenarios predominantly arise from inpatient or post-acute care environments. Has discussions with external… more
- Humana (Jefferson City, MO)
- …our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. ... The Behavioral Health Medical Director work assignments involve moderately complex...or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare… more
- Humana (Jefferson City, MO)
- …Become a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to ... to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all...meets compliance timelines. + Conduct comprehensive, timely, and compliant medical necessity reviews for inpatient services +… more
- Humana (Jefferson City, MO)
- …Solutions as needed + Other activities as assigned by the managing Medical Director Travel: While this is a remote position, occasional travel to Humana's ... caring community and help us put health first** The Medical Director relies on fundamentals of CMS...subject matter contribution Preferred Qualifications + Experience in an inpatient environment and/or related to care of a Medicare… more
- Humana (Jefferson City, MO)
- …as needed** + **Other activities as assigned by the managing Medical Director ** Travel: While this is a remote position, occasional travel to Humana's ... caring community and help us put health first** The Medical Director relies on fundamentals of CMS...subject matter contribution** **Preferred Qualifications** + Experience in an inpatient environment and/or related to care of a Medicare… more
- Sumitomo Pharma (Jefferson City, MO)
- …a dynamic, highly motivated, and experienced individual for the position of Associate Director , Market Access Engagement - Rare Disease, who will act as the face ... access/commercial experience. Rare disease experience is preferred + Excellent virtual/ remote customer engagement skills along with verbal and written communication… more
- Cognizant (Jefferson City, MO)
- …. Draft and submit the medical necessity determinations to the Health Plan/ Medical Director based on the review of clinical documentation in accordance with ... **Schedule:** Monday to Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced level work… more